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Background
Minimising patients' throughput times in hospitals is a hot topic in healthcare. Central facilities such as diagnostic imaging departments often have a large impact on patients' throughput times. 1 One of the major bottlenecks in many hospitals is MRI. For this reason, access times for MRI facilities is one of the main performance indicators for radiology departments. 2 Because these facilities are a very expensive resource, capacity is deliberately limited, which results in high access times. To reduce access times, one possibility would be to increase the MRI capacity. Another, more economical way would be to better utilise the available capacity.
Because an MRI facility is an appointment-based resource, the scheduling strategy applied greatly affects its utilisation. Inappropriate scheduling is common in hospitals, 3 and is often the result of scheduling strategies that have developed over time. Partial adjustments to the strategies are usually for medical reasons, with too little concern for the system performance indicators, such as access times and utilisation rate. More attention should be paid to improving MRI appointment scheduling. Because real-time experimentation can have a significant negative impact on patients and costs, modelling is an appropriate technique for testing promising scheduling improvements. Although other studies have shown that modelling scheduling strategies can support the optimisation of the scheduling process in radiology departments, 4-6 they often did not take into account the different scheduling times for different protocols.
The MRI scanning facility in a university hospital has to deal with high degrees of variability in the process. The most frequently used modelling techniques (such as analytical models) do not take this variability into account. In contrast, discrete event simulation is more appropriate because it is a modelling technique that will give very specific quantitative results when variability is important. 3 7 8 Although discrete event simulation has been applied within radiology modalities, 9 so far it has not been used for complex appointment systems like those in MRI facilities.
The aim of this study was to reduce MRI access times to less than 14 days by optimising the scheduling strategy and implementing this strategy in practice. The objectives of this study were:
to undertake process analysis of the MRI scan scheduling process;
to apply computer simulation to test strategies to measure...